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Eating disorders affect all ages

Q: I am a 55-year-old woman who struggled with an eating disorder (anorexia) during my teen years. As I get older, it’s becoming harder and harder to keep excess weight off, and I’m afraid I may be slipping back into unhealthy old behaviors to lose weight. Are eating disorders common in older women?

A: Feeling youthful inside is great, but a glance in the mirror may bring you up short. No matter how young you feel, you’re likely to see some wrinkles, sags, tummy fat and less firm muscles, due to the weakening elastic tissue and natural muscle loss that come with aging.

Of course, you know that when you see a model or celebrity touted as looking “good for her age,” it’s the work of plastic surgeons, colorists, stylists and airbrushers — but your unretouched body image can’t help but suffer by comparison.

If you feel you should look as good as celebrities your own age, even though their public images may be artificial, your self-esteem can suffer. And this can, in turn, lead to extreme eating habits aimed at weight loss, without regard for your own well-being. Since you have a past history of eating disorders, you’re more susceptible than most.

Eating disorders are usually regarded as a problem of adolescents and young women; their prevalence among older women is less clear. Secrecy and shame often accompany these disorders, and women may not seek help — particularly if they fear being forced to gain unwanted weight or stigmatized as having a “teenager’s disease.”

Despite the underdiagnosis of eating disorders in older people, health professionals are now reporting an upswing in requests for help from older women. For some of these women, the problem is new, while others have struggled with disordered eating for decades.

This dissatisfaction matters. A negative body image can suggest or prefigure a full-blown eating disorder — or a “sub-clinical” problem in which a woman never becomes alarmingly thin but organizes her life around food and weight control.

First, you need a thorough medical examination. Certain medical conditions that cause rapid weight loss, interfere with appetite or make eating difficult can be confused with an eating disorder. Tell your doctor about any experiences with weight loss or gain, eating disorder behaviors or use of drugs to control weight. Your doctor also needs to know about any emotional problems you’re confronting, including depression and anxiety. And if your doctor feels you could benefit from an expert in eating concerns, ask for a referral to a specialist.

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Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.